文章基本信息

标题：Acute Leukemia Relapse Presenting as Recurrent Involvement of the Optic Nerve
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作者：Lee, Seung Yeop ; Yoon, Ji Hyun ; Chung, Seung Ah 等
期刊名称：Journal of the Korean Ophthalmological Society
印刷版ISSN：0378-6471
出版年度：2020
卷号：61
期号：3
页码：319-324
DOI：10.3341/jkos.2020.61.3.319
出版社：The Korean Ophthalmological Society
摘要：Purpose To report two cases with recurrent involvement of the optic nerve as the initial sign of acute leukemic relapse. Case summary An 8-year-old male with acute lymphoblastic leukemia on the maintenance chemotherapy was referred for a decrease in visual acuity in the right eye. The visual acuity and optic disc swelling were completely resolved with high-dose steroid therapy. Two months after the initial presentation, the symptoms recurred and brain/orbit magnetic resonance imaging (MRI) showed high intensity along the right optic nerve from the retrobulbar area to the optic chiasm. The visual acuity was restored after high-dose steroid therapy. One month after the second attack, the symptoms recurred and the cerebrospinal fluid cytology was positive for lymphoblasts. Three weeks after the intrathecal chemotherapy, the visual acuity improved fully, but optic disc atrophy developed. A 45-year-old male, who received allogenic peripheral blood stem cell transplantation for acute myeloid leukemia, presented with a decrease in visual acuity in the left eye. The left optic disc swelling improved with high-dose steroid therapy, but the medication was restarted due to the recurrence of symptoms 3 weeks later. Brain MRI showed a mass lesion compressing the left optic nerve, presumed to be a myeloid sarcoma. One month after local irradiation, the visual acuity was no light perception in the left eye. Conclusions In patients with a prior history of acute leukemia, the recurrent involvement of the optic nerve should be considered as a central nerve system relapse, regardless of improvement with steroid treatment..
关键词：Acute lymphoblastic leukemia; Acute myeloid leukemia; Myeloid sarcoma; Optic nerve; Steroids